# SANTA ROSA POSTACUTE CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northvine Postacute Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558883645
- **Authorized official:** MANEESH A. BANSAL (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (424) 349-7108

## Contact information

- **Practice address:** 446 ARROWOOD DR, SANTA ROSA, CA 95407-7503
- **Practice address phone:** (707) 528-2100
- **Practice address fax:** (562) 457-5584
- **Mailing address:** 721 N EUCLID ST STE 200, ANAHEIM, CA 92801-4116
- **Mailing address phone:** (424) 349-7108
- **Mailing address fax:** (562) 457-5584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/11/2017
- **Last updated:** 11/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 056259 | — | CA |